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dc.contributor.authorWei, Feixue
dc.contributor.authorGaisa, Michael M
dc.contributor.authorD'Souza, Gypsyamber
dc.contributor.authorXia, Ningshao
dc.contributor.authorGiuliano, Anna R
dc.contributor.authorHawes, Stephen E
dc.contributor.authorGao, Lei
dc.contributor.authorCheng, Shu-Hsing
dc.contributor.authorDonà, Maria Gabriella
dc.contributor.authorGoldstone, Stephen E
dc.contributor.authorSchim van der Loeff, Maarten F
dc.contributor.authorNeukam, Karin
dc.contributor.authorMeites, Elissa
dc.contributor.authorPoynten, I Mary
dc.contributor.authorDai, Jianghong
dc.contributor.authorCombes, Jean-Damien
dc.contributor.authorWieland, Ulrike
dc.contributor.authorBurgos, Joaquin
dc.contributor.authorWilkin, Timothy J
dc.contributor.authorHernandez, Alexandra L
dc.contributor.authorIribarren Díaz, Mauricio
dc.contributor.authorHidalgo-Tenorio, Carmen
dc.contributor.authorValencia Arredondo, Marleny
dc.contributor.authorNyitray, Alan G
dc.contributor.authorWentzensen, Nicolas
dc.contributor.authorChow, Eric Pf
dc.contributor.authorSmelov, Vitaly
dc.contributor.authorNowak, Rebecca G
dc.contributor.authorPhanuphak, Nittaya
dc.contributor.authorWoo, Yin Ling
dc.contributor.authorChoi, Yoojin
dc.contributor.authorHu, Yifei
dc.contributor.authorSchofield, Alice M
dc.contributor.authorWoestenberg, Petra J
dc.contributor.authorChikandiwa, Admire T
dc.contributor.authorHickey, Andrew C
dc.contributor.authorde Pokomandy, Alexandra
dc.contributor.authorMurenzi, Gad
dc.contributor.authorPéré, Hélène
dc.contributor.authorDel Pino, Marta
dc.contributor.authorOrtiz, Ana P
dc.contributor.authorCharnot-Katsikas, Angella
dc.contributor.authorLiu, Xing
dc.contributor.authorChariyalertsak, Suwat
dc.contributor.authorStrong, Carol
dc.contributor.authorOng, Jason J
dc.contributor.authorYunihastuti, Evy
dc.contributor.authorEtienney, Isabelle
dc.contributor.authorFerré, Valentine M
dc.contributor.authorZou, Huachun
dc.contributor.authorSegondy, Michel
dc.contributor.authorChinyowa, Simbarashe
dc.contributor.authorAlberts, Catharina J
dc.contributor.authorClifford, Gary M
dc.date.accessioned2021-08-23T18:46:29Z
dc.date.available2021-08-23T18:46:29Z
dc.date.issued2021-07-30
dc.identifier.urihttp://hdl.handle.net/10713/16452
dc.description.abstractBackground: Robust age-specific estimates of anal human papillomavirus (HPV) and high-grade squamous intraepithelial lesions (HSIL) in men can inform anal cancer prevention efforts. We aimed to evaluate the age-specific prevalence of anal HPV, HSIL, and their combination, in men, stratified by HIV status and sexuality. Methods: We did a systematic review for studies on anal HPV infection in men and a pooled analysis of individual-level data from eligible studies across four groups: HIV-positive men who have sex with men (MSM), HIV-negative MSM, HIV-positive men who have sex with women (MSW), and HIV-negative MSW. Studies were required to inform on type-specific HPV infection (at least HPV16), detected by use of a PCR-based test from anal swabs, HIV status, sexuality (MSM, including those who have sex with men only or also with women, or MSW), and age. Authors of eligible studies with a sample size of 200 participants or more were invited to share deidentified individual-level data on the above four variables. Authors of studies including 40 or more HIV-positive MSW or 40 or more men from Africa (irrespective of HIV status and sexuality) were also invited to share these data. Pooled estimates of anal high-risk HPV (HR-HPV, including HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68), and HSIL or worse (HSIL+), were compared by use of adjusted prevalence ratios (aPRs) from generalised linear models. Findings: The systematic review identified 93 eligible studies, of which 64 contributed data on 29 900 men to the pooled analysis. Among HIV-negative MSW anal HPV16 prevalence was 1·8% (91 of 5190) and HR-HPV prevalence was 6·9% (345 of 5003); among HIV-positive MSW the prevalences were 8·7% (59 of 682) and 26·9% (179 of 666); among HIV-negative MSM they were 13·7% (1455 of 10 617) and 41·2% (3798 of 9215), and among HIV-positive MSM 28·5% (3819 of 13 411) and 74·3% (8765 of 11 803). In HIV-positive MSM, HPV16 prevalence was 5·6% (two of 36) among those age 15–18 years and 28·8% (141 of 490) among those age 23–24 years (ptrend=0·0091); prevalence was 31·7% (1057 of 3337) among those age 25–34 years and 22·8% (451 of 1979) among those age 55 and older (ptrend<0·0001). HPV16 prevalence in HIV-negative MSM was 6·7% (15 of 223) among those age 15–18 and 13·9% (166 of 1192) among those age 23–24 years (ptrend=0·0076); the prevalence plateaued thereafter (ptrend=0·72). Similar age-specific patterns were observed for HR-HPV. No significant differences for HPV16 or HR-HPV were found by age for either HIV-positive or HIV-negative MSW. HSIL+ detection ranged from 7·5% (12 of 160) to 54·5% (61 of 112) in HIV-positive MSM; after adjustment for heterogeneity, HIV was a significant predictor of HSIL+ (aPR 1·54, 95% CI 1·36–1·73), HPV16-positive HSIL+ (1·66, 1·36–2·03), and HSIL+ in HPV16-positive MSM (1·19, 1·04–1·37). Among HPV16-positive MSM, HSIL+ prevalence increased with age. Interpretation: High anal HPV prevalence among young HIV-positive and HIV-negative MSM highlights the benefits of gender-neutral HPV vaccination before sexual activity over catch-up vaccination. HIV-positive MSM are a priority for anal cancer screening research and initiatives targeting HPV16-positive HSIL+.en_US
dc.description.urihttps://doi.org/10.1016/S2352-3018(21)00108-9en_US
dc.language.isoenen_US
dc.publisherElsevier Inc.en_US
dc.relation.ispartofThe lancet. HIVen_US
dc.rights© 2021 World Health Organization; licensee Elsevier. This is an Open Access article published under the CC BY-NC-ND 3.0 IGO license.en_US
dc.subject.lcshAgeen_US
dc.subject.lcshAnusen_US
dc.subject.meshHIVen_US
dc.subject.meshMenen_US
dc.subject.meshPapillomavirus Infectionsen_US
dc.subject.meshSquamous Intraepithelial Lesionsen_US
dc.titleEpidemiology of anal human papillomavirus infection and high-grade squamous intraepithelial lesions in 29 900 men according to HIV status, sexuality, and age: a collaborative pooled analysis of 64 studiesen_US
dc.typeArticleen_US
dc.identifier.doi10.1016/S2352-3018(21)00108-9
dc.identifier.pmid34339628
dc.source.countryNetherlands


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